Provider solutions

From managing claims to investigating fraud, insurers typically allocate a large number of labor hours to manual review, leaving a high potential for human error. At illumifin, we combine our deep industry experience with our robust technical capabilities to create unique industry-first services that automate time-consuming processes and improve accuracy and efficiency. Our digital solutions leverage the latest technology to help enhance communication among providers, policyholders and carriers, improving the overall business process.

Care provider solutions

Our innovative digital insurance provider solutions help transform the claims environment — bending cost curves, minimizing administrative work through automation, and driving risk awareness, interventions and management.

Claims Clearinghouse

The Claims Clearinghouse is a digital claims platform which connects software systems from both home care agencies as well as skilled nursing and assisted living facilities to illumifin’s claims administration platform, eLTCAS. In addition, the Clearinghouse is also able to connect to other outside claims administration platforms, making this a truly universal platform for invoice processing. As the only LTC Clearinghouse solution in the industry today, the platform digitizes claim invoices, reducing time and labor spent on manual efforts like faxing, data entry, and follow up calls. The digital invoices produced through the Clearinghouse help expedite review and approval of claim payments.

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Unified Provider Database

This detailed provider directory contains records for over 150,000 providers throughout the country. The information in the database contains provider profiles, licenses, liability certificates, and W9 details for a wide range of provider types including home care, assisted living, skilled nursing, adult daycare, independent providers, and hospice agencies. Access to the Unified Provider Database promotes efficiencies by utilizing a central source for information in determining provider eligibility decisions.

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Fraud Detection & Investigation

Our insurance fraud solutions automate detection by pairing advanced technology with long-term care fraud experts to surface fraud, waste, and abuse risks throughout the claims cycle.

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Cost of Care

Our Cost of Care survey considers costs associated with long-term care, giving our clients the information their customers need to make the best financial decisions for their family’s future.

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Electronic Visit Verification

CareExchange is illumifin’s Electronic Visit Verification (EVV) software which eliminates the use of paper timesheets, creating efficiencies for claimants, providers, and carriers. The EVV platform is also another important piece in our fraud detection strategy and is integrated with illumifin’s Fraud Sentry platform to provide valuable insights and trends to help carriers minimize suspicious claims.

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Feature spotlight


illumifin’s online provider platform allows long-term care providers to digitally update key information such as licensure, coverage areas and insurance credentials. The data entered in to the portal populates several other consumer and carrier facing platforms, such as Caregiver Advocate, What Care Costs, and the Unified Provider Database.

Your best choice for insurance provider solutions

Deep industry experience

With an average of 25+ years working in insurance, our leadership team has a comprehensive understanding of the challenges facing the industry.

Convenient delivery

Our solutions are available to all carriers a la carte, as bundled self-service solutions or through our business processing services solutions.

White labeling

White label customization is available for public-facing sites, documents, and applications for a consistent customer experience.

API integration

We offer API integrations to our solutions, so you can easily expand your existing capabilities within a familiar interface.

Get in touch

Want to learn more about how our insurance provider solutions can help your company increase revenue and efficiency?